病毒性心肌炎患者外周血心肌酶谱和miR-26b miR-19b表达变化分析及与预后的关系

doi:10.3969/j.issn.1006-6233.2023.07.011

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Abstract Objective: To investigate the changes of myocardial enzymology indexes in peripheral blood,serum micrornA-26b (miR-26b),micrornA-19b (miR-19b) and their relationship with prognosis in patients with viral myocarditis. Methods: A total of 116 patients with viral myocarditis admitted to our hospital from November 2020 to August 2022 were selected as the myocarditis group,and 60 cases non-myocarditis volunteers who underwent physical examinations during the same period were selected as the control group.The myocardial enzyme indicators,serum miR-26b,and miR-19b levels of the two groups were compared,and the patients were grouped based on the 6-month follow-up prognosis.The general information and research indicators of the two groups were compared.Logistic regression analysis was used to identify relevant indicators that affected the prognosis of patients with viral myocarditis. Results: The expression levels of ALT,AST,LDH,cTnI,CK-MB,CK,and miR-19b in patients with myocarditis were higher than those in the control group,and the difference was statistically significant (P<0.05); the relative expression intensity of miR-26b in patients with myocarditis was lower than that in the control group,and the difference was statistically significant (P<0.05); according to a 6-month follow-up,there were 36 patients with poor prognosis,including 2 deaths,18 hospitalizations for recurrent heart failure,9 hospitalizations for arrhythmia,and 7 relapses of myocarditis; there was no statistically significant difference in age,BMI,gender and chest pain between the group with good prognosis and the group with poor prognosis (P>0.05); the systolic blood pressure and diastolic blood pressure in the poor prognosis group were lower than those in the good prognosis group,and the heart rate,chest tightness,myocardium,fatigue,respiratory rate,atrial flutter/atrial fibrillation,atrioventricular block and bundle branch block in the poor prognosis group were higher than those in the good prognosis group,with a statistically significant difference (P<0.05); the expression levels of ALT,AST,LDH,cTnI,CK-MB,CK and miR-19b in patients with poor prognosis were higher than those in patients with good prognosis,and the difference was statistically significant (P<0.05); the relative expression intensity of miR-26b in patients with poor prognosis was lower than that in patients with good prognosis,and the difference was statistically significant (P<0.05); the results of logistic regression analysis showed that atrial flutter/atrial fibrillation,atrioventricular block,bundle branch block,increased ALT,AST,LDH,cTnI,CK-MB,CK,miR-19b and miR-26b were independent risk factors for poor prognosis in patients with myocarditis (P<0.05). Conclusion: In patients with viral myocarditis,peripheral blood myocardial enzymology indexes and miR-19b expression were significantly increased,and miR-26b expression was significantly decreased,which was closely related to poor prognosis of patients.

Key words： Viral myocarditis Myocardial enzymology miR-26b miR-19b

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.07.011 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I7/1114

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